N2 ch.24
An older adult client comes to the health center reporting difficulty sleeping. Which statement by the client would the nurse need to address? "I try not to be too active once I've eaten dinner." "I find myself napping on and off throughout the day." "I go to bed around 10:30 pm every night." "I don't drink coffee or alcohol."
"I find myself napping on and off throughout the day." The client's statement about napping throughout the day will need to be addressed by the nurse because this can interfere with the client's ability to sleep at night. Avoiding activity after dinner, having a routine bedtime, and avoiding caffeine and alcohol are healthy sleep habits.
A nurse is conducting an education session about appropriate measures to promote sleep with an older adult who is experiencing frequent awakenings at night and then awakening early in the morning. The nurse determines that the education was successful when the client states: "I should do some mild exercises about 2 hours before bedtime." "I need to try and go to bed and get up at the same time each night." "I should continue to take my sleep medication for as long as I need to." "I should avoid coffee, but tea is okay to drink before bed."
"I need to try and go to bed and get up at the same time each night." Sleep measures include maintaining a routine, going to bed and getting up at the same time each night, avoiding exercise 3 to 4 hours before bed, using prescribed sleep medications only for the short-term (7 to 14 days), and avoiding alcohol, nicotine, and caffeine (which tea contains).
An older adult is admitted to the health care facility with a diagnosis of depression. The nurse would be especially alert for: poor cognitive performance. sleep problems. lack of initiative. suicidal thoughts.
suicidal thoughts. Although poor cognitive performance, sleep problems, and lack of initiative are manifestations of depression, the nurse should be alert for indications of suicidal thoughts or behaviors. Suicide is the most serious consequence of depression.
Based on an understanding of the cognitive changes that normally occur with aging, what might the nurse expect a newly hospitalized older adult to do? talk rapidly but be confused withdraw from strangers interrupt with frequent questions take longer to respond and react
take longer to respond and react The nurse would expect a newly hospitalized older adult to take longer to respond and react. It is normal for an older adult to take longer to respond and react, particularly in new or unfamiliar surroundings. Knowing this, the nurse should slow the pace of care and allow older clients extra time to ask questions or complete activities.
A nurse is teaching an older adult client's family about the causes of mental impairment. The nurse sees that the teaching has been effective when the family says which of the following? "Dementia is an acute process and develops suddenly." "Sundowning is a common problem of dementia." "Delirium progressively affects cognitive function and is a chronic process." "Alzheimer's disease (AD) is a reversible neurologic illness."
"Sundowning is a common problem of dementia." A common problem in clients with dementia is sundowning syndrome, in which an older adult habitually becomes confused, restless, and agitated after dark. Dementia is chronic and usually develops gradually. AD is the most common degenerative illness and is irreversible. Delirium, a temporary state of confusion, is an acute illness that can last from hours to weeks and resolves with treatment.
A nursing student is studying depression in older adults. Faculty members knows the student has mastered the information when she states which of the following? "Sadness is most often associated with suicidal intent." "Depression can resolve without treatment." "Depression is usually not accompanied by changes in behavior." "Treatment of depression includes counseling."
"Treatment of depression includes counseling." Treatment of depression usually involves psychotherapy or counseling along with antidepressant medication. In an older adult, hopelessness rather than sadness is more often associated with suicidal intent. Depression usually does not resolve without treatment and is frequently underdiagnosed. There is usually a distinct change of behavior accompanied by other specific signs and symptoms of depression.
The nurse is caring for an older adult client who is confused and agitated. When the client's family comes to visit the nurse asks how long the client has been confused. The family states that the client has been confused for a long time and the confusion is getting worse. The client is subsequently diagnosed with dementia. What is the most common cause of dementia in an older adult client? Delirium Depression Excessive drug use Alzheimer's disease
Alzheimer's disease Alzheimer's disease is the most common cause of dementia in older adults. Approximately 10% of people over age 65 have Alzheimer's disease; about 50% of people over age 85 have the disease. Delirium, or acute confusion, is caused by an underlying disease and is not itself a cause of dementia. Depression is common in older adults but, in many cases, manifests itself in apathy, self-deprecation, or inertia — not dementia. Excessive drug use, commonly stemming from the client seeing multiple health care providers who are unaware of drugs that other health care providers have prescribed, can cause dementia. Although it is a problem among older adults, it is not as common as Alzheimer's disease.
A 79-year-old female is admitted to a long-term care facility. She is incontinent of urine and feces and has impaired cognition. What is the best nursing intervention to prevent skin breakdown for this resident? Turn her every hour when in bed Ask her to call the nurse when she feels the need for elimination Insert an indwelling catheter to prevent urine from causing skin breakdown Assist her to the toilet every 2 hours and after meals
Assist her to the toilet every 2 hours and after meals Implementing a toileting schedule will help prevent skin breakdown. Turning will not address the incontinence issue. Since the resident has poor cognition, asking her to notify the nurse for elimination needs is unrealistic. An indwelling catheter may increase her risk for infection and will not address the fecal incontinence.
The nurse is evaluating a 42-year-old client who says that they are feeling stressed. Which of the following does the nurse know that could be a cause of stress for this age group? Being caught in the sandwich generation Retirement Losing driving privileges Social isolation
Being caught in the sandwich generation Middle-aged adults may be caught in a "generation sandwich," which includes involvement with children as well as aging parents and other family members. Retirement, the loss of driving privileges, and social isolation are often stressors for the older adult.
A gerontologic nurse practitioner has a large client population with heart disease problems. This nurse practitioner is aware that heart disease is the leading cause of death in the aging adult. What is the cause of this trend? Blood vessels lose their elasticity with age. Systolic blood pressure decreases with age. Resting heart rate decreases with age. The cardiac output is increased with age.
Blood vessels lose their elasticity with age. In the aging adult, the blood vessels become less elastic. Because the blood vessels become more rigid, increase in blood pressure can result. The body is less able to increase heart rate and cardiac output with activity.
What term is used to describe various disorders that progressively affect cognitive function? Dementia Ageism Reminiscence Delirium
Dementia Dementia describes various disorders that progressively affect cognitive function. Delirium is a temporary state of confusion that can last from hours to weeks and resolves with treatment. Ageism is a form of prejudice, like racism, in which older adults are stereotyped by characteristics found in a few members of their group. Reminiscence is the phenomenon of an older adult telling stories of the past.
An adult child accompanies an older adult client to the clinic and states, "I am not sure what is going on with my parent but I think it is depression." What questions should the nurse ask the client to determine if he or she is depressed? Select all that apply. "Can you tell me what your sleep patterns are?" "Have you had any changes in weight recently such as a gain or loss?" "Have you been seeing things that no one else seems to see?" "What foods do you like to eat?" "Have you lost interest in things you previously found pleasurable?"
Can you tell me what your sleep patterns are?" "Have you had any changes in weight recently such as a gain or loss?" "Have you lost interest in things you previously found pleasurable?" Extreme or prolonged sadness in an older adult may be a warning sign of depression. Depression is not a normal part of aging. Death of a spouse or friends and changes in living environment and financial resources can precipitate feelings of grieving that, if unresolved, may result in depression. There is usually a distinct change of behavior accompanied by other specific signs and symptoms of depression, such as sleep disturbances, weight loss (sometimes gain), difficulty with concentration, irritability or anger, loss of interest in once pleasurable activities, vague pains, crying, fatigue, and suicidal thoughts or preoccupation with death. Visual hallucinations are not part of the symptoms of depression and may be indicative of another form of mental illness or have an organic cause. Finding out what foods the client eats does not ask a question that relates to finding out if the client is depressed.
The nurse is assessing a middle-aged adult age 48 years in the clinic. The nurse recalls the changes that occur in middle age as they complete the physical and cognitive examination. Changes that occur include what? Cardiac output decreases. Loss of fatty tissue Low-pitched sounds are more difficult. Visual acuity changes with myopia.
Cardiac output decreases. Middle age changes include the following: redistribution of fatty tissue around the middle and abdomen; drier skin; wrinkles develop; hair grays and men may experience baldness; cardiac output decreases; near-vision diminishes; presbyopia; hearing diminishes, especially high-pitched sounds; hormone levels decrease; calcium loss from bone occurs; decrease in muscle strength.
The nurse is advocating for thorough, timely and assertive management of pain in older adults. Which older adult client should the nurse monitor most closely for insufficient pain management? Client whose pain is not linked to a known cause or injury Client with a history of four hospital admissions over the past year Client who is a White woman who lives alone Client living with type 2 diabetes
Client whose pain is not linked to a known cause or injury Chronic pain, or ongoing pain after expected time of healing, may or may not be linked with a cause or actual injury yet is the most common issue presented to healthcare professionals in people 65 years and older. For clients whose source of pain is unknown, there is a possibility that their reports of pain may be downplayed or ignored. Diabetes, White race, and repeat admissions are not directly linked to systematic undertreatment of pain.
The home care nurse is performing a visit to assess a client's venous ulcer and perform wound care. The nurse observes that there is very little nutritious food in the house, no adequate heat, and the client states, "My daughter takes my pension check and spends it every month." What is the nurse's most appropriate action? Document the statement and report it to police promptly Collaborate with the supervisor and social work to plan a response Arrange for a family meeting, ensuring that the daughter is able to attend Advocate for the client's admission to the emergency department
Collaborate with the supervisor and social work to plan a response While reporting obligations vary slightly in different jurisdictions, the nurse should always liaise with supervisors and social work to discuss suspicions of abuse and to craft a response that is in line with ethical and legal obligations. Unless the client is in grave and immediate peril, a hospital admission or police report would not take place immediately. Engaging with the daughter in a meeting before seeking appropriate guidance would be unsafe.
An older adult client enjoys good overall health, but has just been diagnosed with pneumonia and has begun receiving an intravenous (IV) antibiotic. Shortly after being administered the first dose, the client pulled out his IV line and is now attempting to scale his bed rails. Which of the following phenomena most likely underlies this change in the client's cognition? Delirium Dementia Disorientation Depression
Delirium Delirium is a temporary state of confusion that is often precipitated by drug interactions or the effects of new drugs. Dementia is rooted in organic brain changes and rarely has a sudden onset. The client is not showing signs or symptoms of depression. Disorientation is a manifestation of a problem rather than a cause.
A 78-year-old client is status post right hip fracture after a fall. They have stopped going to their church over the past few months. They have also asked their neighbor to help them and do their gardening, an activity they previously loved. The client tells the nurse "I just don't enjoy gardening like I used to. I am always worried about falling." What would most concern the nurse regarding the client? Depression Generalized anxiety disorder Realistic caution Bipolar disorder
Depression The nurse should assess the client and determine if depression is occurring first. Depression can be treated and the client's condition improved. If depression is not the issue, then the nurse could further assess and determine if there is another issue which should be addressed.
A nurse is reading a journal article about mood disorders in the older adult population. Which information about these conditions would the nurse expect to find? Select all that apply. Depression is often misdiagnosed. Symptoms often mimic those of other chronic comorbidities of the older adult. Depression is considered a normal part of aging. The stigma associated with depression is less for older adults. Suicide is the most serious consequence of depression.
Depression is often misdiagnosed. Symptoms often mimic those of other chronic comorbidities of the older adult. Suicide is the most serious consequence of depression Mood disorders (especially depression) are often unrecognized or misdiagnosed in older adults partly due to the false belief that depression is a natural reaction to illness, advanced age, or life changes that occur with age. Therefore, depression is not viewed as something that needs to be treated in the older adult. Furthermore, symptoms of depression may include poor cognitive performance, sleep problems, and lack of initiative ? symptoms commonly seen in people with multiple chronic comorbidities (such as diabetes or heart failure) or in clients with dementia or delirium, causing it to be unrecognized. Although depression is not a normal part of aging, older adults are at an increased risk of experiencing depression due to chronic illness and other age-related changes. The older adult population is also less likely to report symptoms due to the stigma attached. Suicide is the most serious consequence of depression.
The nurse understands that when caring for the older adult it is important to assist in maintaining independence and self-esteem. Assisting the client to adjust to a walker or wheelchair is an example of supporting which of Erikson's developmental tasks of the older adult? Adaptation to age and preservation of self Ego integrity and coping with reality of limitations Functional adaptation and self-awareness Prevention of injury and safety in navigation
Ego integrity and coping with reality of limitations Age does affect the older adult due to many different physiological changes, as evidenced by a decrease of cardiac output, peripheral circulation, oxygenation of blood, decreased ability to control temperature, and a slower heart rate. Ego integrity is the task of the older adult, according to Erikson, including "wholeness," emotional integration, and acceptance of physical decline. The others are not developmental tasks described by Erikson.
Gould viewed the middle years as a time when adults increase their feelings of self-satisfaction, value their spouse as a companion, and become more concerned with health. Which nursing action best facilitates this process? Counseling a client who complains of being depressed Providing entertainment for a client on bedrest Arranging for social services to assist with meals for a homebound client Encouraging a client to have regular checkups
Encouraging a client to have regular checkups Gould viewed the middle years as a time when adults look inward (ages 35 to 43); accept their lifespan as having definite boundaries, and have a special interest in spouse, friends, and community (ages 43 to 50); and increase their feelings of self-satisfaction, value spouse as a companion, and become more concerned with health (ages 50 to 60). The nursing action that best facilitates this process would be encouraging a client to have regular checkups.
Erikson identified ego integrity vs. despair and disgust as the last stage of human development, which begins at about 60 years of age. Which intervention would best foster older clients' ego integrity? Distracting the client Praising the client Encouraging life review Promoting independent living
Encouraging life review The intervention that would best foster older clients' ego integrity would be encouraging life review. Older adults search for emotional integration and acceptance of the past and present, as well as acceptance of physiologic decline without fear of death. Older adults often like to tell stories of past events. This phenomenon, called life review or reminiscence, has been identified worldwide. In a sense, this is a way for an older adult to relive and restructure life experiences and is part of achieving ego integrity. Integrity vs. despair and disgust would not be fostered by distracting the client, praising the client, or promoting independent living.
An older adult client is becoming progressively confused due to Alzheimer's disease. The family can no longer manage the client at home due to wandering. Which of the following living arrangements could the nurse recommend? Respite care Naturally occurring retirement communities (NORCs) Extended-care facility Accessory apartment
Extended-care facility If the older adult is cognitively impaired, family caregivers face the need for daily care giving, such as that which is provided in an extended-care facility. Respite care is temporary housing and NORCs enable the client to remain at home. Accessory apartments are separate apartments constructed, in part, out of an existing house and do not have any health care services.
Which of the following health promotion measures should occur most frequently in older adult women? Fecal occult blood test Pelvic and Papanicolaou (Pap) exam Colonoscopy Tetanus booster
Fecal occult blood test Fecal occult blood tests are recommended annually for older adults. Pap exams and pelvic exams are recommended at least every 3 years. Colonoscopy or sigmoidoscopy should be performed every 3 to 5 years, and a tetanus booster is only necessary every 10 years.
The middle adult is sometimes called the "sandwich generation". According to Erikson, the developmental task of the middle adult is what? Initiative versus guilt Ego-integrity versus despair Generativity versus stagnation Goal attainment versus crisis
Generativity versus stagnation The developmental task of the middle adult is "generativity versus stagnation." They are in a stage of guiding the next generation, accepting their own changes and adjusting to need of aging parents, as well as evaluating their own goals and accomplishments. "Initiative versus guilt" is the developmental task for toddlers. "Ego integrity versus despair" is the developmental task for older adults. "Goal attainment versus crisis" is not a developmental task.x
The nurse is assigned to care for a client age 87 years admitted to the medical unit for congestive heart failure. It is the fourth hospital day, and the response to treatment has been good. The client is no longer short of breath and the lung sounds are clearing. There is still a diet restriction of decreased sodium and fluids are limited to no more than 1000 mL per day. The nurse is preparing the client and family for discharge. The nurse's discharge education, in order to promote the older client's health, will include which instructions? Select all that apply. Gradually increase activities as tolerated. Do not use the salt shaker at meals. Increased stress may interfere with recovery. Take several naps during the day.
Gradually increase activities as tolerated. Do not use the salt shaker at meals. Increased stress may interfere with recovery.
An older adult client comes to the senior center for a check-up. During the visit, the client tells the nurse that they know they should be more active. The nurse reinforces the client's statement, explaining that physical activity helps to lower the risk of which condition? Select all that apply. Heart disease Stroke Diabetes Anxiety Arthritis
Heart disease Stroke Diabetes Physical activity is good for all people including the older adult. Being physically active (1) lowers the risk of heart disease, stroke, and diabetes, (2) reduces depression symptoms, and (3) improves thinking (Health People 2020). Staying active will increase or maintain strength and balance, allowing for continued independence and the prevention of injuries. Activity may be used to address symptoms of anxiety but it will not help lower the risk for anxiety. Arthritis can interfere with the older adult's ability to engage in physical activity.
A nurse encourages residents of a long-term care facility to continue a similar pattern of behavior and activity that existed in their middle adulthood years to ensure healthy aging. This intervention is based on which aging theory? Identity-continuity theory Disengagement theory Activity theory Life review theory
Identity-continuity theory The identity-continuity theory assumes that healthy aging is related to the older adult's ability to continue similar patterns of behavior from young and middle adulthood. Older adults search for emotional integration and acceptance of the past and present, as well as acceptance of physiologic decline without fear of death. Older adults often like to tell stories of past events. This phenomenon, called life review or reminiscence, has been identified worldwide. Disengagement theory maintains that older adults often withdraw from usual roles and become more introspective and self-focused. This withdrawal was theorized as intrinsic and inevitable, necessary for successful aging, and beneficial for both the person and for society.
When assessing a client during the middle adult years, the nurse recognizes which of the following as a normal physical change? Increased loss of calcium from the bones Increased levels of energy Increased oil levels in the skin Increased cardiac output
Increased loss of calcium from the bones Some physical changes common during the middle adult years include increased fatigue, decreased cardiac output, increased loss of calcium from the bones, and decreased oil levels (resulting in dry skin).
The nurse is reminiscing with a 72-year-old client with early onset dementia while providing care in a long-term care facility. How does the nurse implement this form of therapy to maximize the therapeutic value? Listen to the client's stories and ask questions to facilitate ego integrity and provide companionship. Ask questions about the client's childhood and any unresolved relationship issues that may be preventing the client's peace and acceptance of the aging process. Ask family members to participate in activities that help the client remember important aspects of life and health so he/she can move through the final stages of aging. Encourage the client to talk about special life experiences so discussions regarding death and dying can be easier and can prepare the client for declining health.
Listen to the client's stories and ask questions to facilitate ego integrity and provide companionship. Reminiscence is a way for an older adult to relive and restructure life experiences and is part of achieving ego integrity. Listening and asking questions also provides a sense of companionship to clients as they often experience loneliness during dementia even though they may have family members that visit. , nor does it support the client's acceptance of declining health status.
A nurse is assessing middle-age adults living in a retirement community. What behavior would the nurse typically see in the middle-age adult? Believes in establishment of self but fears being pulled back into the family Usually substitutes new roles for old roles and perhaps continues formal roles in a new context Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community Looks forward but also looks back and begins to reflect on his or her life
Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community Middle-age adults would be looking inward, accepting the life span as having definite boundaries, and having special interest in spouse, friends, and community. The other options are behaviors of the older adult.
The nurse practitioner is examining a 55-year-old female client. Which of the following findings would be uncommon for this age group? Lower extremity pulses are weak Presbyopia occurs Menopause occurs Agility gradually decreases
Lower extremity pulses are weak Normal physiologic changes of the middle-aged adult do not include peripheral pulses becoming weak and not always palpable. The other options can be seen in a middle-aged adult.
A nurse is providing care at an ambulatory care center to a wide range of older adults from diverse racial and ethnic groups. Based on recent statistics, which group would the nurse most likely identify as projected to be the largest? Blacks Non-Hispanic Whites Hispanics Asians
Non-Hispanic Whites In 2012, 21% of people 65 and over were members of racial or ethnic marginalized populations. Racial and ethnic marginalized groups have increased from 6.1 million in 2002 (17% of the older population) to 8.9 million in 2012 (21% of the older population) and are projected to increase to 20.2 million in 2030 (28%% of the older population). Between 2012 and 2030, the white non-Hispanic population 65 years or older is projected to increase by 54%, compared with 123.5% for older racial and ethnic marginalized identity groups, including Hispanics (155%); Blacks (104%); American Indian and Native Alaskans (116%); and Asians (119%).
A nurse caring for older adults in a long-term care facility is teaching a novice nurse characteristic behaviors of older adults. Which statement is not considered ageism? Old age begins at age 65. Personality is not changed by chronologic aging. Most older adults are ill and institutionalized. Intelligence declines with age.
Personality is not changed by chronologic aging. Ageism is a form of prejudice, like racism, in which older adults are stereotyped by characteristics found in only a few members of their group. Fundamental to ageism is the view that older people are different and will remain different; therefore, they do not experience the same desires, needs, and concerns as other adults. The statement not considered ageism would be that personality is not changed by chronologic aging. Most older adults are not ill and institutionalized. Intelligence does not decline with age. Old age does not begin at age 65.
An client 81 years of age is in a long-term-care facility. His family could no longer cope with his progressing senile dementia, including wandering away and unpredictable behavior. Late one night the nurse finds the client wandering in the hall. He says he is looking for his wife. What should the nursing approach should be? Use a matter-of-fact attitude and gently help him back to his room. Remind him that he must not get up unassisted and should stay in his room at night. Remind him of where he is and assess why he is having difficulty sleeping. Allow him to sleep in the recliner in the day-room, so he will not disturb other clients.
Remind him of where he is and assess why he is having difficulty sleeping. Reminding the client where he is will help orient him to his surroundings. Assessment is needed to determine any need that may be disturbing the client, such as the need to use the bathroom, feeling cold/warm, etc. The other responses do not include orienting the disoriented/confused client.
A nurse is assessing an older adult with impaired thinking, mood and communication. The nurse would expect to find that the client is most likely experiencing problems with which activity initially? Select all that apply. Shopping Managing finances Cooking Bathing Feeding Ambulating
Shopping Managing finances Cooking Conditions that mimic dementia or depression present distinct challenges because they impair thinking, mood, and communication. Such conditions also affect the older adult's ability to manage self-care. Activities such as shopping, managing finances, and cooking are usually affected first. As the number or severity of impairments increases, the older adult will lose his ability to bathe, feed, and ambulate.
An 86-year-old client on the medical inpatient unit informs the nurse that the hospital is quite noisy and that they are having difficulty sleeping. Which is not true regarding sleep in the older adult? Sleep medications are usually the first choice in treating sleep disturbance. Stage 1 sleep increases in the older adult. Deep sleep declines in the older adult. Chronic cardiovascular or respiratory illness can interfere with sleep.
Sleep medications are usually the first choice in treating sleep disturbance. Medications are typically the last choice for treating sleep disturbance because they can interact with other medications or have paradoxical effects on the older adult.
A public health nurse is participating in a health fair that is being held at a local community center. The nurse should encourage adult participants to completely eliminate which of the following from their diet and lifestyle? Smoking Alcohol Salt Cholesterol
Smoking
A nurse has attended an inservice workshop that addressed the phenomenon of ageism in the health care system. Which of the following practices is indicative of ageism? Implementing falls prevention measures in a setting where older adults receive care Providing slightly smaller servings of food for clients who are older adults Speaking to older adults with the presumption that they have mild cognitive deficits Assessing the skin turgor of an older adult differently than that of a younger adult
Speaking to older adults with the presumption that they have mild cognitive deficits Accommodation of normal, age-related changes such as decreased skin turgor and slightly decreased nutritional needs is not an indication of ageism. Similarly, safety measures are unlikely to be motivated by ageist beliefs. Assuming that all older adults have cognitively deficits, however, is an indication of ageism.
Which activity performed by an older adult client should prompt the client and family to be assessed for changes in mental status or dementia? The client's bathroom faucet has developed a steady drip and they have not reported it The client is an accountant and has made three unprecedented bookkeeping errors The client used to go for a walk daily but now goes two to three times weekly The client is uncertain of their medication regimen since three new medications were added
The client is an accountant and has made three unprecedented bookkeeping errors Uncharacteristic lapses in judgement, memory or performance may necessitate a mental status exam. Uncertainty about a major change in medications or a lack of response to a minor household maintenance issue do not necessarily signal a cognitive deficit. A change in physical functioning can have numerous potential causes and is less likely to be caused by a cognitive, rather than physical, change.
Which of the following assessment findings of a male client age 77 years should signal the nurse to a potentially pathologic finding, rather than a normal age-related change? The client is oriented to person and place but is unsure of the month. The client states that his urine stream is less strong than in the past. The client claims to hear high-pitched sounds less clearly than earlier in life. The client's gait is slow and his posture appears stooped.
The client is oriented to person and place but is unsure of the month. Age-related physiologic changes include a weakening of bladder emptying, presbycusis, and a slow gait that may be accompanied by stooped posture. Disorientation to time, however, should always prompt the nurse to perform further assessment and should never be considered a normal accompaniment to the aging process.
A nurse is providing discharge instructions to an older adult client and their adult child. The adult child asks for suggestions to help keep their parent healthy. Which of the following could the nurse suggest? The adult child can talk to the client's health care provider about taking a vitamin B supplement. The client should have a physical examination every 3 years. The client should have their eyes examined every year for glaucoma. The client should limit carbohydrates in their diet.
The client should have their eyes examined every year for glaucoma. The nurse should teach the client and their family general health-promotion activities, including having the client's vision checked yearly, which includes checking for glaucoma; for those over 40 years of age, an annual physical examination; eating a diet that includes all food groups and is low in fat, saturated fat, and cholesterol; and discussing with the health care provider whether to include vitamin D supplementation.
A nurse is preparing a presentation for a group of older adults about health promotion. Which statistic would the nurse need to keep in mind about this group? Life expectancy has increased for men but not for women. The group experiencing the largest growth is those 85 years of age and older. The number of older adults has begun to plateau since the year 2000. The older adult population appears to be younger than in the past.
The group experiencing the largest growth is those 85 years of age and older. The older population itself is older than it has been in the past. In 2012, the 65-74 age range was more than 10 times larger than in 1900; however, in contrast, the 75-84 age group was 17 times larger, and those age 85 years or older was 48 times larger. Life expectancy has increased for both men and women. Worldwide, the number of older adults has grown exponentially. Since 1900, the percentage of individuals 65 years or older has tripled, and the number has increased over 13 times. The older adult population itself is older than it has been in the past.
The gerontological nurse oversees community-based care and is assigning resources on the basis of demographic trends in older adults. Which information should inform the nurse's decision-making? A minority of adults over 65 reside with a spouse One-third of adults over 75 live in assisted living, long-term care or other institutional settings Half of adults over age 65 live alone There are more than three times more widows than widowers
There are more than three times more widows than widowers As of 2021, over three times as many widows (9.1 million) as widowers (2.7 million). The proportion of adults living alone generally increases with age, but this population remains a minority. In 2019, only a relatively small number (1.2 million; 4%) of older adults lived in institutional settings. A majority of older adults live with a spouse.
A nurse arrives at the home of an older adult client. The agency was called because a neighbor noticed that the client was home alone. The nurse finds the client alone in the living room. When asked about the client's adult child who lives there and has been caring for them, the client says, "They went on vacation for about a month. They'll be back soon." Further assessment reveals that there are no other family members or services currently involved. The nurse would identify this situation as: abandonment. exploitation. neglect. emotional abuse.
abandonment. The client is alone and without any support or caregivers. Therefore, abandonment, which is the desertion or a vulnerable older adult by anyone who has assumed responsibility for that adult's care, would apply. Exploitation involves illegally taking or misusing funds, property, or assets of a vulnerable older adult. Neglect involves refusal or failure by those responsible to provide food, shelter, protection, or health care for a vulnerable older adult. Emotional abuse involves verbally or nonverbally causing mental pain, anguish or distress on the older adult.
When describing the older adult's risk for infection, which aspect would the nurse most likely address? Select all that apply. enhanced immune function decline in humoral immunity lowered antibody responses inadequate nutrition maintenance of T-cell function
decline in humoral immunity lowered antibody responses inadequate nutrition As people age, their immune systems become less efficient. Humoral immunity declines because of changes in T-cell function, and older adults have lower antibody response to microorganisms that cause influenza and pneumonia (Frasca, et al, 2010). Inadequate nutrition and chronic illnesses adversely affect the immune system and the ability to ward off infection. Without proper nutrients, basic body functions lack the necessary vitamins, minerals, and food substances (proteins, carbohydrates, and fats) to maintain optimal functioning.
An older adult client is prescribed a sleep medication. When explaining the medication to the client, the nurse would emphasize which aspect of therapy? greatest effectiveness with short term use minimal risk of adverse effects rare occurrences of confusion need for follow-up laboratory tests
greatest effectiveness with short term use Sleep medications may be used, but these drugs are most effective when limited to short-term use (7 to 14 days); otherwise, the medications may actually interfere with sleep and cause other adverse outcomes such as falls, confusion, and constipation. The risks for adverse effects depend on the drug prescribed. There is no need for follow up laboratory tests.
A 79-year-old client became a widow earlier this year and now resides alone in the house that they and their spouse shared for 30 years. The client's children have encouraged the client to move, but the client expresses a desire to remain in their home, despite some slight mobility challenges. The nurse who provides occasional home health care for the client should first propose which intervention? home modification assisted living long-term care facility homesharing
home modification Older adults typically express a desire to maintain their existing living relationships and this should be facilitated as long as it is safe. Consequently, the nurse should prioritize the client's wishes. Home modification may allow the client to maximize independence and maintain their current living situation in spite of some mobility challenges.
In a report, the night nurse tells the incoming nurse that one client with dementia. Which nursing concern will the nurse identify to address the client's sundowning syndrome? sleep deprivation social isolation grieving noncompliance
sleep deprivation A common problem in clients with dementia is sundowning syndrome, in which the client habitually becomes confused, restless, and agitated after dark and does not sleep. Implementing the nursing concern of sleep deprivation will help the client obtain adequate sleep at night and awaken refreshed. Social isolation, grieving, and noncompliance are concern that could be related to a client with dementia but are not related to sundowning syndrome.
